262ANNEX IIStandards for Granting Therapeutic use ExemptionsExtract from “INTERNATIONAL STANDARD FORTHERAPEUTIC USE EXEMPTIONS” of the World Anti-dopingAgency (WADA);in force 1 january 20094.0 Criteria for Granting a Therapeutic Use ExemptionA therapeutic use exemption (TUE) may be granted to an Athletepermitting the Use of a Prohibited Substance or Prohibited Methodcontained in the Prohibited List. An application for a TUE will be reviewedby a Therapeutic Use Exemption Committee (TUEC). TheTUEC will be appointed by an Anti-Doping Organization. An exemptionwill be granted only in strict accordance with the following criteria:[Comment: This Standard can apply to all Athletes as defined byand subject to the Code, i.e. able-bodied Athletes and Athletes withdisabilities. This Standard will be applied according to an individual’scircumstances. For example, an exemption that is appropriate for anAthlete with a disability may be inappropriate for other Athletes.]4.1 The Athlete should submit an application for a TUE no less thantwenty-one (21) days before he/she needs the approval for instance anEvent).4.2 The Athlete would experience a significant impairment to healthif the Prohibited Substance or Prohibited Method were to be withheld inthe course of treating an acute or chronic medical condition.4.3 The therapeutic Use of the Prohibited Substance or ProhibitedMethod would produce no additional enhancement of performance otherthan that which might be anticipated by a return to a state of normalhealth following the treatment of a legitimate medical condition. TheUse of any Prohibited Substance or Prohibited Method to increase “lownormal”levels of any endogenous hormone is not considered an acceptabletherapeutic intervention.4.4 There is no reasonable therapeutic alternative to the Use of theotherwise Prohibited Substance or Prohibited Method.4.5 The necessity for the Use of the otherwise Prohibited Substanceor Prohibited Method cannot be a consequence, wholly or in part, ofprior nontherapeuticUse of any substance from the Prohibited List.4.6 The TUE will be cancelled by the granting body, if:a. The Athlete does not promptly comply with any requirementsor conditions imposed by the Anti-Doping Organization granting theexemption.

3 26b. The term for which the TUE was granted has expired.c. The Athlete is advised that the TUE has been withdrawn by theAnti-Doping Organization.[Comment: Each TUE will have a specified duration as decided uponby the TUEC. There may be cases when a TUE has expired or has beenwithdrawn and the Prohibited Substance subject to the TUE is stillpresent in the Athlete’s body. In such cases, the Anti-Doping Organizationconducting the initial review of an adverse analytical finding willconsider whether the finding is consistent with expiry or withdrawal ofthe TUE.]4.7 An application for a TUE will not be considered for retroactiveapproval except in cases where:a. Emergency treatment or treatment of an acute medical conditionwas necessary, orb. due to exceptional circumstances, there was insufficient time oropportunity for an applicant to submit, or a TUEC to consider, anapplication prior to Doping Control, orc. the conditions set forth under 7.13 apply.[Comment: Medical emergencies or acute medical situations requiringadministration of an otherwise Prohibited Substance or ProhibitedMethod before an application for a TUE can be made, are uncommon.Similarly, circumstances requiring expedited consideration of an applicationfor a TUE due to imminent competition are infrequent. Anti-Doping Organizations granting TUEs should have internal procedureswhich permit such situations to be addressed.]5.0. Confidentiality of Information5.1 The applicant must provide written consent for the transmissionof all information pertaining to the application to members of the TUECand, as required, other independent medical or scientific experts, or toall necessary staff involved in the management, review or appeal ofTUEs .Should the assistance of external, independent experts be required, alldetails of the application will be circulated without identifying the Athleteconcerned. The applicant must also provide written consent for thedecisions of the TUEC to be distributed to other relevant Anti-DopingOrganizations under the provisions of the Code.5.2 The members of the TUECs and the administration of the Anti-Doping Organization involved will conduct all of their activities in strictconfidence. All members of a TUEC and all staff involved will sign confidentialityagreements. In particular they will keep the following informationconfidential:

264a. All medical information and data provided by the Athlete andphysician(s) involved in the Athlete’s care.b. All details of the application including the name of the physician(s)involved in the process.Should the Athlete wish to revoke the right of the TUEC or the WADATUEC to obtain any health information on his/her behalf, the Athletemust notify his/her medical practitioner in writing of the fact. As a consequenceof such a decision, the Athlete will not receive approval for aTUE or renewal of an existing TUE.6.0 Therapeutic Use Exemption Committees (TUECs)TUECs shall be constituted and act in accordance with the followingguidelines:6.1 TUECs should include at least three (3) physicians with experiencein the care and treatment of Athletes and a sound knowledge ofclinical, sports and exercise medicine. In order to ensure a level of independenceof decisions, the majority of the members of any TUEC shouldbe free of conflicts of interest or political responsibility in the Anti-Doping Organization.All members of a TUEC will sign a conflict of interest agreement. Inapplications involving Athletes with disabilities, at least one TUECmember must possess specific experience with the care and treatment ofAthletes with disabilities.6.2 TUECs may seek whatever medical or scientific expertise theydeem appropriate in reviewing the circumstances of any application fora TUE.6.3 The WADA TUEC shall be composed following the criteria setout in Article 6.1. The WADA TUEC is established to review on its owninitiative TUE decisions granted by Anti-Doping Organizations. Asspecified in Article 4.4 of the Code, the WADA TUEC, upon request byAthletes who have been denied TUEs by an Anti-Doping Organization,will review such decisions with the power to reverse them.7.0 TherapeuticUse Exemption (TUE) Application Process7.1 A TUE will only be considered following the receipt of a completedapplication form that must include all relevant documents (seeAnnex 2 – TUE form). The application process must be dealt with inaccordance with the principles of strict medical confidentiality.7.2 The TUE application form(s), as set out in Annex 2, can be modifiedby Anti-Doping Organizations to include additional requests forinformation, but no sections or items shall be removed.7.3 The TUE application form(s) may be translated into other language(s)by Anti-Doping Organizations, but English or French mustremain on the application form(s).

5 267.4 An Athlete may not apply to more than one Anti-Doping Organizationfor a TUE. The application must identify the Athlete’s sport and,where appropriate, discipline and specific position or role.7.5 The application must list any previous and/or current requests forpermission to use an otherwise Prohibited Substance or ProhibitedMethod, the body to whom that request was made, and the decision ofthat body.7.6 The application must include a comprehensive medical historyand the results of all examinations, laboratory investigations and imagingstudies relevant to the application. The arguments related to the diagnosisand treatment, as well as duration of validity, should follow theWADA “Medical Information to Support the Decisions of TUECs”. Forasthma, the specific requirement(s) set out in Annex 1 must be fulfilled.7.7 Any additional relevant investigations, examinations or imagingstudies requested by the TUEC of the Anti-Doping Organization beforeapproval will be undertaken at the expense of the applicant or his/hernational sport governing body.7.8 The application must include a statement by an appropriatelyqualified physician attesting to the necessity of the otherwise ProhibitedSubstance or Prohibited Method in the treatment of the Athlete anddescribing why an alternative, permitted medication cannot, or couldnot, be used in the treatment of this condition.7.9 The dose, frequency, route and duration of administration of theotherwise Prohibited Substance or Prohibited Method in question mustbe specified. In case of change, a new application should be submitted.7.10 In normal circumstances, decisions of the TUEC should be completedwithin thirty (30) days of receipt of all relevant documentationand will be conveyed in writing to the Athlete by the relevant Anti-Doping Organization.In case of a TUE application made in a reasonable time limit prior toan Event the TUEC should use its best endeavors to complete the TUEprocess before the start of the Event. Where a TUE has been granted toan Athlete in the Anti-Doping Organization Registered Testing Pool, theAthlete and WADA will be provided promptly with an approval whichincludes information pertaining to the duration of the exemption and anyconditions associated with the TUE.7.11 a. Upon receiving a request by an Athlete for review, the WADATUEC will, as specified in Article 4.4 of the Code, be able to reversea decision on a TUE denied by an Anti-Doping Organization. TheAthlete shall provide to the WADA TUEC all the information for aTUE as submitted initially to the Anti-Doping Organization accompaniedby an application fee. Until the review process has been completed,the original decision remains in effect. The process should nottake longer than thirty (30) days following receipt of all the informationby WADA.b. WADA can, on its own initiative, undertake a review at anytime.

2667.12 If the decision regarding the granting of a TUE is reversed byWADA upon review, the reversal shall not apply retroactively and shallnot disqualify the Athlete’s results during the period that the TUE hadbeen granted and shall take effect no later than fourteen (14) days followingnotification of the decision to the Athlete.7.13 The Use of inhaled Beta-2 Agonists:– The Use of inhaled formoterol, salbutamol, salmeterol, terbutalinereflects current clinical practice. The Use of these substancesshould be declared on ADAMS where reasonably feasible and inaccordance with the Code as soon as the product is used and must aswell be declared on the Doping Control form at the time of Testing.Failure to declare will be taken into account in the result managementprocess in particular in case of application for a Retroactive TUE.– Athletes using the substances listed above by inhalation musthave a medical file justifying this Use and meeting the minimumrequirements outlined in Annex 1.Depending upon the category of the Athlete, the medical file willbe evaluated as follows:– For all Athletes included in an International Federation RegisteredTesting Pool a regular TUE approved before the Use of the substance.– For Athletes participating in an International Event but who are notincluded in an International Federation Registered Testing Pool either aTUE, or a Retroactive TUE in the case of an Adverse Analytical Finding,in accordance with the rule of the International Federation or of theMajor Event Organization.– For national-level Athletes who are not included in an InternationalFederation Registered Testing Pool, whether or not they are part of anational Registered Testing Pool, either a TUE, or a Retroactive TUE inthe case of an Adverse Analytical Finding, in accordance with the rulesof the National Anti-Doping Organization.– No Retroactive TUE will be granted if the requirements of Annex1 are not met meaning that any Adverse Analytical Finding reported bylaboratory in these circumstances will result in an anti-doping rule violation.– Any Athlete may apply for a TUE at any time if they wish.– Any Athlete who has applied for a TUE or a Retroactive TUE andwho was denied such TUE may not use the substance without the priorgranting of a TUE (no Retroactive TUE will be permitted).8.0 Declaration of Use Process8.1 It is acknowledged that some substances included on the List ofProhibited Substances are used to treat medical conditions frequentlyencountered in the athlete population. For monitoring purposes, thesesubstances, for which the route of administration is not prohibited, will

7 26require a simple declaration of use. These are strictly limited to:Glucocorticosteroids used by non systemic routes, namely intraarticular,periarticular, peritendinous, epidural, intradermal injections and inhaledroute.8.2 For the mentioned substances, the declaration of Use should bedone through ADAMS where reasonably feasible and in accordance withthe Code by the Athlete at the same time as the Use starts. This declarationshould mention the diagnosis, the name of the substance, the doseundertaken, the name and the contact details of the physician.In addition, the Athlete must declare the Use of the substance in questionon the Doping Control form.9.0 Clearinghouse9.1 Anti-Doping Organisations are required to provide WADA withall TUEs approved for Athletes who are part of a national or internationalRegistered Testing Pool, and all supporting documentation, inaccordance with section 7.9.2 The declarations of use should be available to WADA (ADAMS).9.3 The clearinghouse shall guarantee strict confidentiality of all themedical information.10.0 Transitional provisionAbbreviated Therapeutic Use Exemptions (ATUEs) delivered priorto December 31, 2008 shall remain governed by the 2005 TUE Standard.These ATUEs shall remain valid after January 1, 2009 until the earliestof:(i) The date on which they are cancelled by the competent TUEC followingreview in accordance with art. 8.6 of the 2005 TUE Standard;(ii) Their expiry date as mentioned on the ATUE;(iii) December 31, 2009.C. VERTALINGZie Trb. 2006, 194.Voor een correctie in de vertaling zie Trb. 2007, 5.D. PARLEMENTZie Trb. 2007, 5.

2612PartijOndertekeningRatificatie Type * InwerkingOpzeggingBuitenwerkingZuid-Afrika 30-11-06 R 01-02-07Zuid-Korea 05-02-07 R 01-04-07Zweden 09-11-05 R 01-02-07Zwitserland 23-10-08 T 01-12-08* O=Ondertekening zonder voorbehoud of vereiste van ratificatie, R= Bekrachtiging,aanvaarding, goedkeuring of kennisgeving, T=Toetreding, VG=Voortgezette gebondenheid,NB=Niet bekendUitbreidingenChinaUitgebreid tot In werking Buiten werkingHong Kong SAR 01-02-2007Macau SAR 01-02-2007Verenigd Koninkrijk, hetUitgebreid tot In werking Buiten werkingAlderney 01-02-2007Bermuda 01-02-2007Cayman-eilanden 01-02-2007Falkland-eilanden 01-02-2007Guernsey 01-02-2007Jersey 01-02-2007Man 01-02-2007Verklaringen, voorbehouden en bezwarenArgentinië, 29 december 2006The Argentine Republic rejects the claim to extend to the FalklandIslands the application of the International Convention against Dopingin Sport, adopted in Paris on 19 October 2005 by the General Conferenceof UNESCO, notified to the Director-General of UNESCO by theUnited Kingdom of Great Britain and Northern Ireland on 25 April2006, and reaffirms its rights of sovereignty over the integral part of itsnational territory and, being illegaly occupied by the United Kingdom of

13 26Great Britain and Northern Ireland, are the subject of a sovereignty disputebetween the two countries, which has been recognized by severalinternational organizations.In this regard, the General Assembly of the United Nations, adoptedresolutions 2065 (XX), 3160 (XXVIII), 31/49, 37/9, 38/12, 39/6, 40/21,41/40, 42/19 and 43/25, in which it recognized the existence of a disputeover sovereignty in relation to the question of the Falkland Islands andurged the Argentine Republic and the United Kingdom of Great Britainand Northern Ireland to initiate negotiations with a view to finding apeaceful and lasting solution to the sovereignty dispute as soon as possible.For its part, the Special Committee on Decolonisation of theUnited Nations had repeatedly made similar appeals, most recently in deresolution adopted on 15 June 2006. Similarly, the General Assembly ofthe Organization of American States adopted a new resolution on thesubject on 6 June 2006.Denemarken, 15 december 2005Unless so decided at a later date the Convention shall not apply to theFaroe Islands and Greenland.Nieuw-Zeeland, 23 december 2005AND DECLARES that, consistent with the constitutional status of Tokelauand taking into account the commitment of the Government of NewZealand to the development of self-government for Tokelau through anact of self-determination under the Charter of the United Nations, thisacceptance shall not extend to Tokelau unless and until a Declaration tothis effect is lodged by the Government of New Zealand with theDepositary on the basis of appropriate consultation with that territory.Verenigde Staten van Amerika, de, 25 augustus 2008The Senate of the United States of America by its resolution of July 21,2008, two-thirds of the Senators present concurring therein, gave itsadvice and consent to ratification of the Convention subject to the followingunderstanding:It is the understanding of the United States of America that nothing inthis Convention obligates the United States to provide funding to theWorld Anti-Doping Agency.The Senate’s advice and consent is subject to the following declaration:Pursuant to Article 2 (4), which defines “Athlete” for purposes of dopingcontrol as “any person who participates in sport at the internationalor national level as defined by each national anti-doping organizationand accepted by States Parties and any additional person who participatesin a sport or event at a lower level accepted by States Parties”, theUnited States of America declares that “Athlete” for purposes of dopingcontrol means any athlete determined by the U.S. Anti-Doping Agencyto be subject to or to have accepted the World Anti-Doping Code.